Performing Department
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Non Technical Summary
To address challenges related to the chronic disease burden in Arkansas, and the health disparities between urban and rural populations, this proposal employs an asset-based community development model, in combination with a lay-leader health training program, that equips community volunteers with the health education and promotion knowledge and skills necessary to lead Extension-based health programs in targeted rural counties.Through this model, the proposed project aims to empower and give agency to volunteers who live in and belong to the communities they serve by identifying human-capital assets that drive the community development process and work to respond to and create local opportunity for addressing community health concerns. Rural, adult residents of the target counties, including under-resourced and underserved populations, serve as the primary audience for this proposal.One of the primary objectives will be to employ the asset-based community development (ABCD) framework to identify community members who could serve as Extension Health Ambassadors (EHAs). This identification process leads into the training of EHAs to deliver health programs with the supervision of County Extension Agents. Ultimately, these EHAs increase access to and availability of Extension health-related programming for rural populations in the target counties.The proposed project team has a successful history of providing culturally-appropriate community health outreach, education, program implementation, evaluation, and training for rural and hard-to-reach populations throughout Arkansas.This approach bridges the gap between diverse populations and improved health, and builds capacity and human capital toward health promotion and the identification of strategies for reducing chronic disease.
Animal Health Component
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Research Effort Categories
Basic
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Applied
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Developmental
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Goals / Objectives
The primary purpose of this project is to amplify and broaden the reach of Extension health programming in rural communities by training target community volunteers through a community health worker model to deliver health-related programs, alongside County Extension Agents, to larger Extension audiences than could be accoomplished by just the extension agent alone.Objectives:1) Employ ABCD community engagement model for recruiting Extension Health Ambassadors from target communities2) Develop and implement health education training materials and modules to equip County Extension Agents and community volunteers to deliver community-based, health-related Extension programs3) Increase access to and availability of Extension health-related programs delivered by Extension Health Ambassadors in target counties
Project Methods
The project will utilize a community health worker model to train community volunteers to become EHAs. These trained Ambassadors will then deliver health-related programs, alongside County Extension Agents (CEAs), to larger Extension audiences than could be accomplished by just the CEA alone. Through this model, the project aims to empower and give agency to volunteers who live in and belong to the communities they serve.Community volunteers will be expected to complete the Extension Health Ambassador Training Program (Appendix A), consisting largely of online, self-paced knowledge- and skill-enrichment courses, covering topics that include nutrition and physical activity across the lifespan; mental and emotional health; health literacy and numeracy; rural health; chronic disease in Arkansas and the U.S.; cultural competency; social determinants of health; and, health behavior theory, as examples. CEAs will also complete this training and serve as county-level leadership for their volunteers. Each CEA will be tasked, using the ABCD strategy, with identifying up to five community volunteers who will undertake training to become EHAs.Through the EHA program, ABCD will be used to recruit volunteers and sustain a place-based, community-focused process that results in a culture of inclusivity built on a relationship-driven approach, realizing that each community responds in different ways and has different resources. In recruiting volunteers, we will build systematic approach to identifying the challenges and adopting solutions.Once trained, EHAs will be tasked with delivering Extension health-related programming alongside CEAs, who will oversee program delivery and fidelity. As part of this program delivery process, and in concert with the Project Evaluation Lead, EHAs will evaluate community participant knowledge and behavior change.Evaluation activities for the proposed project will follow the processes outlined in the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) and CIRO (Context, Input, Reaction, Output) models. RE-AIM will be used to determine the impact and effectiveness of EHA in the context of 1) volunteer recruitment and training completion, 2) whether project activities are taking place at expected rates, 3) whether targeted audiences are being reached, and 4) whether trained volunteers are actively involved and being retained. In addition, data reported by participating CEAs through the Arkansas Information Management System (AIMS) database will be used for output and outcome data within the scope of RE-AIM. AIMS is the online accountability database for the University of Arkansas System Division of Agriculture Cooperative Extension Service. The CIRO model is a process evaluation model that will be used to determine the volunteer training's effectiveness through 1) training needs and 3-level objectives (immediate, intermediate, ultimate), 2) training delivery format and maintenance, 3) participant feedback on the training's content, approach, and value, and 4) the results of the training as determined by long-term engagement of volunteers. The RE-AIM and CIRO models have been integrated into the EHA logic model and data management plan. Return on investment will be determined by the value of volunteer hours along with the expanded reach the volunteers have added to county programming. This will be determined through the number of sessions taught and the number of people reached. The evaluation will ensure program activities are implemented as intended and meet performance metrics. In addition, the evaluation will help inform adaptations and improvements to the implementation of the program and will measure program effectiveness.